Did you see the latest study about Diet and Exercise and Type 2?

The current issue of the Journal of the American Medical Association includes a study where people with type 2 diabetes were randomly assigned to either an intensive lifestyle intervention program or to a control group.

Here are some interesting tidbits from the report:• 11.5% of participants in the intensive intervention were able to achieve non-diabetic blood sugar levels without the need for medication.

• The intervention included a calorie-restricted diet (1200 to 1800 calories/day) and an exercise program of just under 3 hours of physical activity per week.

• The control group received a "few annual counseling sessions." (By the way, 2% of the control group achieved the same results.)

OK, here are the real kickers for me coming out of this. One of the outcomes of the intervention that was being measured was a reduced risk of heart disease. Sadly, even this intensive intervention failed to reduce that risk.

And the other kicker: "less than one-third of people whose diabetes went into remission during the program managed to keep their blood sugar levels down for at least four years."

So for me this brings up some really interesting things for us to discuss. First of all, do you think an intervention this intense is worth it? If you were part of the 11.5% who got off medications, would you feel it was worth it?

Second, why do you think two-thirds of those who did get off their medications were not able to maintain that kind of control over a long period of time? Is it that diabetes just keeps progressing? Or is it just unrealistic to eat like that and exercise that much ALL the time?

6 replies

Jigsaw shared the link he posted below with me previously, and it made me think of several factors that may have something to do with those results. Nowhere in the study does it say what the make-up of the groups was, so I can only assume that some people in the groups were “more diabetic” than others. In contrast to Jigsaw, I’m one of the lucky ones (so far) that has gained control through weight loss. Ideally this will last the rest of my life, but I’m not banking on it. If that is the case, could there possibly be a subset of Type 2 that is temporary such as “obesity diabetes” much like gestational diabetes? Since there are so many contributing factors to diabetes and its severity, I suspect there’s more than one answer to why that two-thirds couldn’t manage long term results.

My wife and I both went through an “intensive lifestyle intervention program” for weight loss which is where my control began. I’m of the opinion that this need not be a lifelong thing, provided you don’t slip back into old habits like several folks here have already mentioned usually happens. Since I stayed on my diet and the wife didn’t, I would say that was probably a big factor in why that two-thirds never gained long term control. I have relaxed a bit on carb intake and exercise, but only to the point where I maintain my current weight and BG numbers.

I do believe in the intensive intervention process. It kind of acts as a “reboot”. If you clean your slate, then only add back in what you really need, it seems to be a lot more effective than just trying to delete things a little at a time or work up to a certain point. My theory is if you give it 100% and fail 20% (and fail you will), at least you’re in it at 80%. If you only give it 50% and only fail 10, you’re only in it at 40%.

I have to relate this in part to some of my own personal experience. Through diet, exercise and lifestyle change in general, I believe I accomplished quite a bit. I was able to stay off meds for the 1st 7 years after being diagnosed. My cholesterol dropped 100 points down to 135, and my triglycerides dropped tremendously also from 750 to 80. My wife was amazed at my self control as to diet and exercise. Eighteen years with diabetes and amazingly, I have no complications. I suspect that I may not be alive today if not for my regimin over the years ! I know I would definitely have health problems. So yes, I believe intense treatment and or therapy has benefits for most people.

Currently, and approximately the last two years, I am using some insulin. My diabetes has definitely progressed to the point that without insulin, I would not be able to get the nutrients necessary to stay healthy. One strawberry would raise my bg about 40 points. So for me and for many, I do believe that diabetes will progress in spite of intensive therapy or excellent health care.

Interestingly, I have never really been overweight more than about 10 pounds.There does seem to be some differences with the way diabetes affects very heavy or obese people, that have lost weight as compared to those that have never had a weight problem.

I honestly believe that so many people are unwilling to change their diet, for the long haul even though the outcome is worth it health wise.We want what we want right now, a quick fix, and not to feel deprived. Exercise for some is something they struggle to do. More people need support like we all have here

I believe this was a poor designedstudy. first type 2 was the qualificationsfor the study…that is very wide…werethey on meds …what meds …how longhave they been type II …how about comorbities ?poor study…the results more likely to hurt than help.